Question

what does a nurse assess for in patient with chronic insomnia

what nursing interventions are needed

Answer 1

Assessment

identify any medical or psychological illness that may be contributing to your insomnia. For example, you may be asked about chronic snoring and recent weight gain, which might suggest sleep apnea as the cause of insomnia. You will also likely be asked questions to see if you are suffering from anxiety, depression or other conditions that may keep you from getting a good night’s sleep.

Tests Used to Diagnose Insomnia

Sleep diary: Tracking your sleep patterns may help your doctor reach a diagnosis.

Epworth Sleepiness Scale: a validated questionnaire that is used to assess daytime sleepiness.

Polysomnogram: a test measuring activity during sleep.

Actigraphy: a test to assess sleep-wake patterns over time. Actigraphs are small, wrist-worn devices (about the size of a wristwatch) that measure movement.

Mental Health Exam: Because insomnia may be a symptom of depression, anxiety, or another mental health disorder, a mental status exam, mental health history, and basic psychological evaluations may be part of your initial assessment.

Interventions

• Establishing and adhering to a regular sleep time and wake time for the client based on their patterns and needs.
• Limiting the duration and frequency of day time naps.
• The promotion of daily exercise.
• The avoidance of alcohol, caffeine, heavy meals
• exercise at least a couple of hours before bedtime.
• Determine patterns of sleep in the past in a normal environment: amount, bedtime routines, depth, length, positions, aids, and other interfering factors
• Take note observations of sleep-wake behaviors. Take down notes on the number of hours the patient is asleep.
• Evaluate the patient’s knowledge on the cause of sleep problems and potential relief measures to facilitate treatment.
• Observe and evaluate the timing or effects of medications that can affect sleep.
• Educate the patient on the proper food and fluid intake such as avoiding heavy meals, alcohol, caffeine, or smoking before bedtime.
• Introduce relaxing activities such as warm bath, calm music, reading a book, and relaxation exercises before bedtime.
• Suggest patient to get out of bed temporarily and perform a relaxing activity if unable to sleep 30-45 minutes in bed.